首页|Development of a Widely Applicable and Simple Prognostic Score for Patients with Acute-on-chronic Liver Failure
Development of a Widely Applicable and Simple Prognostic Score for Patients with Acute-on-chronic Liver Failure
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NETL
NSTL
万方数据
维普
Background and Aims: Acute-on-chronic liver failure (ACLF) tends to progress rapidly with high short-term mor-tality. We aimed to create a widely applicable, simple prog-nostic (WASP) score for ACLF patients. Methods: A retro-spective cohort of ACLF cases recruited from three centers in China were divided into training and validation sets to de-velop the new score. A prospective longitudinal cohort was recruited for further validation. Results: A total of 541 cas-es were included in the training set, and seven independent ACLF prognostic factors were screened to construct a new quantitative WASP-ACLF table. In the validation set of 671 cases, WASP-ACLF showed better predictive ability for 28-day and 90-day mortality than the currently used prognos-tic scores at baseline, day 3, week 1, and week 2. The pre-dictive efficacy and clinical validity of the model improved over time. Patients were assigned to low-, intermediate-, and high-risk groups by their WASP-ACLF scores. Compared with the other two groups, intermediate-risk patients had a more uncertain prognosis, with a 90-day mortality of 44.4–50.6％. Sequential assessments at weeks 1 and 2 found the 90-day mortality of intermediate-risk groups was <20％ for patients with a ≥2 point decrease in WASP-ACLF and was up to 56％ for patients with a ≥2 points increase. Similar re-sults were observed in prospective data. Conclusions: The new ACLF prognostic score was simple, widely applicable, and had good predictive efficacy. Continuous assessments and trend of change in WASP-ACLF need to be considered, especially for intermediate-risk patients.
Zhenjun Yu、Yu Zhang、Yuhan Li、Feng Zhou、Manman Xu、Shaoli You、Yu Chen、Bing Zhu、Ming Kong、Fangjiao Song、Shaojie Xin、Zhongping Duan、Tao Han、China Network for Severe Liver Diseases
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Department of Hepatology and Gastroenterology,The Third Central Clinical College of Tianjin Medical University,Tianjin,China
Liver Disease Center(Difficult and Complicated Liver Diseases and Artificial Liver Center),Beijing You'an Hospi-tal Affiliated to Capital Medical University,Beijing,China
Liver Failure Treatment and Research Center,The Fifth Medical Center of Chinese PLA General Hospital,Beijing,China
Department of Gastroenterology and Hepatology,Tianjin UnionMedical Center Affiliated to Nankai University,Tianjin,China
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National 13th 5-Year Plan for Hepatitis Research国家自然科学基金国家自然科学基金天津市自然科学基金
NETL
NSTL
万方数据
维普
